Matthew Douglas Adams, ATC, OTC
Individual provider Active NPI Athletic Trainer · Johnson City, TN
NPI 1619264355 · NPPES record last updated Jul 1, 2011
Key facts
- NPI
- 1619264355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1146 (SC)
- Practice address
- 3 Professional Park Dr Ste 21
Johnson City, TN 37604-6529 - Phone
- (423) 434-6300
- Fax
- (423) 434-6312
- NPI assigned
- Jul 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1146 | SC | Yes |
Addresses
Primary practice location
3 Professional Park Dr Ste 21
Johnson City, TN 37604-6529
Mailing address
3 Professional Park Dr Ste 21
Johnson City, TN 37604-6529
Other providers in Johnson City, TN
- Huthaifah Aburumman
- Crystal Adams
- Don E Adams III
- Ezra Allen Adams
- Joseph A Adams
- Misty Dawn Adams
- Santana Nikcole Adams
- Shane M Adams
- Brittnea Jean Adcock
- Emmanuel Kojo Addo-Yobo
All providers in Johnson City, TN · Athletic Trainer in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.